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Credit Dispute Form
Full Name
*
Street Address
*
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Email Address
*
Today’s Date
*
Credit Bureau
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Select One
Equifax
Experian
TransUnion
Account Name
*
Dispute Reason
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Select One
Account not mine
Incorrect balance
Incorrect payment status
Account paid but still reporting as unpaid
Duplicate account
Account opened fraudulently
Account was discharged in bankruptcy
Incorrect dates (opened/closed/last reported)
Late payment inaccurately reported
Account closed by consumer, not creditor
Collection account paid but not updated
Re-aged account (dates changed to look recent)
Wrong original creditor
Incorrect credit limit or loan amount
Charged off account still reporting balance
Inaccurate personal information linked to account
Account settled but not reported as settled
Hard inquiry without my permission
Unauthorized inquiry
Judgment or public record does not belong to me
Item is obsolete (older than 7 years)
Other – See notes
Additional Notes (optional)
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